Lactation Program Assessment

Complete the questionnaire to receive a customized assessment of your organization's corporate lactation program.

Work Email*

Company name*

First name*

Last name

Job title

In which state or province is your organization headquartered?

How many locations does your organization have?

2-5

5-9

10+

Other

How many employees in each location?

How many employees had a baby in the last 12 months?

Is there lactation space in every location?

Yes

Other

What equipment is included in your organization's lactation spaces?

Hospital-grade breast pump

Electrical outlet

Pumping chair

Table

Sink

Refrigerated milk storage

Support pillows

Personal drying racks

Hand & equipment sanitizers

Other

Which apply to your organization's lactation spaces?

Rooms are clearly labeled for their intended purpose

Doors can be locked when in use

Windows can be covered when in use

Room is soundproofed

Room is regularly assessed for safety

Room is regularly serviced to maintain supply levels and keep equipment in good working order

What parenting education and support services are available to employees?

One-to-one lactation consultations

Parenting classes

Parenting support groups

One-to-one access to parenting experts

Does your organization provide employee's partners or family members with access to parenting resources?

Yes

Other

Does your organization give gifts to employees after the birth of a baby?

Organization-wide corporate gift program

Varies by location or department

Phone number